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John Deverill is a seasoned healthcare technology and commercial leader based in London, UK, with over two decades of experience in healthcare management and consulting. He currently serves as the Chair of Exhalation Technology Ltd and is the owner of Deverill and Co Limited. His extensive expertise includes strategic leadership, organizational design, and healthcare innovation, making him a valuable contributor to discussions on healthcare technology and cross-sector partnerships. Learn more about him on his expert page.
In this episode of the Org Design Podcast, host Tim Brewer and guest cohost Rory Mustan sit down with John Deverill—former British Army lieutenant colonel, ex-GE Healthcare leader, and current NHS change-maker.
John shares how the disciplines of military leadership translate into organizational agility, what healthcare can learn from the battlefield, and why most organizations evolve by accident rather than intentional design.
From rethinking strategy as “what you actually do,” to building coalitions of the willing, to balancing tradition with innovation, John delivers a masterclass on leading through uncertainty. Whether you’re running a hospital, a corporation, or a fast-growing team, this episode will challenge how you think about leadership, strategy, and organizational resilience.
European Organization Design Forum (EODF)
[00:00:00] Tim Brewer: Welcome to the Org Design Podcast. My name's Tim Brewer. I've got guest cohost Rory joining us. Rory, thank you for coming along. And we've got the pleasure today of having John Deverill joining us we know a little bit about John's past and the current work he's doing at the NHS in England. John, thank you so much for joining us today. You have more experience in Milan? Here, here, in milan or In
[00:00:26] John Deverill: Italy, yes, I'm honored to be an Italian citizen these days, so I like Italy a lot.
[00:00:32] Tim Brewer: We haven't met anyone actually yet on the podcast that said at school when everyone else said they wanted to be astronauts, or lawyers or doctors, that people were running around saying, "oh, I'd like to be an org designer". Tell us a bit about your history and journey, in the study and workforce, and how did you end up getting into org design?
[00:00:50] John Deverill: I think most people end up being in org design, even if they don't know it in reality. In my case, when I was at school, I, and somebody had, if somebody had asked me what I wanted to do, I would've said, I've got absolutely no idea, which would've been the truth.
In the end, I joined the British Army because my father instructed me to join the British Army, which, and it seemed I had no better idea to be fair. And I stayed in the British Army for about 18 years became a lieutenant colonel. I was in charge of different organizations at that point. And the thing about all military forces, especially the armies, maybe you see them marching up and down on parade squares and being shouted at, and it all looks very TikTok and very, very hierarchical.
But in fact, I believe that the army works because it has a hierarchy, but not using the hierarchy. The hierarchy is there for a purpose, and it's so well practiced and it's so well versed in what it does, that it works around it when it needs to. It's extremely agile. And if, if, if armies weren't agile, they wouldn't survive.
And if you think about it, in a war, everything always goes wrong because soldiers are basically young and very scared people, and there's lots and lots of bad people trying to kill you all the time. So everything's always going wrong, and you have to think very carefully about what you're trying to achieve and how to achieve it, and thus reorganize yourself and your forces in order for that to work.
I figured that out by myself as I think most people do. But it was reinforced at Staff college and places like that. Left the army in about 2000. Having had a thoroughly rewarding career, I think had absolutely no idea what to do with my life at that point, became a management consultant. Because I thought management consultancy, you get to learn how to be a civilian or a c as we used to call them. And you also get to see lots and lots of different areas of business so you can figure out what your, your real job is going to be. And as a management consultant, I did various jobs in a consultancy, figured out that the filthy art of selling, which isn't filthy at all, it's about a transaction of value in which if you are, if you have an integrity, things get sold, and if you don't, it doesn't work. Kind of stuff. At least that's, that's my definition. Or if you, otherwise you're misselling and that's not right anyway. 'cause you always get found out. And you need to sell as a consultant because that's where the work comes from and it's, it's a key skill.
As a consultant, I did process flow and a bit of org design actually within a city council that wanted to outsource itself basically, and had to figure out the basic processes it used and reorganize itself and reorganize the back office.
But very quickly I moved across to health and healthcare because having been in the Army for so long, I wanted to make in my mind a, a difference in helping people in a way rather different to maybe what the conventional idea of the arm, the armed forces is. And I met some people very early on, who gave me a hand in health very quickly became totally immersed in it. And I, I love healthcare with a passion because it's so important and I hate it because it's so inefficient. Healthcare like most organizations, we might come back to that depending on the questions you have, but it's normally, it's evolved and not designed. M ost of it, therefore, urgently would benefit from redesign, not least because of all the emergent technologies and things like that. But that means, because you can't go around and hire thousands of other doctors. There aren't enough that you have to bring the workforce with you of course, they're vitally important, which makes it all very, very hard and therefore challenging and therefore rewarding. In the middle of that in a consultancy my friends and I, I guess you could say, we managed to sell, sell the business to a, a great company called GE.
[00:04:30] Rory Mustan: I've heard of them. Yeah,
[00:04:31] John Deverill: no, I've heard of them. I had heard of them before. Coincidentally. Amazing. Yeah. It's so big, so utterly massive and of a sort of similar size to the British Army, hierarchical in a completely different way, with lots of great history and tradition as the Army had had, but completely different at the same time. Really appreciated my time there. This is GE Healthcare.
[00:04:54] Tim Brewer: Mm-hmm.
[00:04:54] John Deverill: Which I left about two years ago, and now I have the, the glittering accolade of having a, a portfolio career in which most of my work is in the NHS. Creating new organizations, new innovations, or trying to make new innovations work through organizational means.
And at that point, because I've been coming to the EODF conference where we are now, since I think the second one. So I, I know lots of people here. Mm-hmm. And I picked up so many ideas, most of which, all good ideas anyway are common sense when you've got your head around them anyway, aren't they? But a lot of them have applicability in the real world. I come here to recharge my intellectual battery. But also to challenge myself to be better in the work that I do every day.
[00:05:35] Tim Brewer: Really It's fantastic. Yeah. Thank And and I think for our listeners who find themselves in leadership positions in unexpected ways, I think hearing that that journey is pretty natural and can come through, in your case, come through the armed forces. But for a lot of people, leadership isn't something they go and study and then not in a senior management position, they tend to get there, on their progression through their career.
[00:06:01] John Deverill: Leadership, it's it's a set of, how do you know you've got leaders? I think by looking for followers who are following for the right reasons, which means you're not whipping them into submission. The look for the followers and you'll find the leaders. I was saying to somebody earlier today actually in the armed forces, you go on a course on leadership, it lasts a year or so, no messing about, life and death, that sort of thing. In civi street, in what we might call the real world, it's not like that, but still, there's no shortage of real leaders here then it is quite remarkable, admirable people. So I think a lot of it is innate. Some of it however, can be taught, all good leaders need the time to think, in order to be deliberate about what they're doing. Otherwise, they're happy chap is that other people are following by out of curiosity, which is marvelous for a while until everything goes horribly wrong,
[00:06:45] Rory Mustan: so by being more conscious about being a leader, you can, you can fulfill that, that role if you're conscious about it.
[00:06:52] John Deverill: I think so, yeah. But there's a confusion isn't there, between leadership roles, which is the jobs people do and leadership, which is the character and determination, which mean that people follow you in achieving your desired outcome. Or it may be, and it is yours because the leader, I believe, anyway, the leader primarily has to own the strategy and the vision of where an organization is going. And it is through character and determination and clarity of view and flexibility and the ability to pivot on a fourpenny piece, which is an old unit of currency for any Australian listeners,
[00:07:32] Tim Brewer: quite small.
[00:07:33] John Deverill: Yes. But to be flexible and agile, that kind of stuff. All of those are things which I think modern leaders need especially, and I work in healthcare, as I said, the rate of change in technology, which maybe isn't just limited to healthcare, but you see an awful lot of it with genomics and that sort of thing means that organizations need to pivot in a way, which is actually, I think faster than the people can usually cope with.
[00:08:00] Tim Brewer: Yeah. I want to go back you were sharing your story, there's that jump out me you highlighted, may to discuss it. which is, I'm
[00:08:07] John Deverill: Oh, I'm so sorry to have mentioned anything
[00:08:08] Tim Brewer: No, no. I think
[00:08:09] John Deverill: that led to any thought,
[00:08:11] Tim Brewer: just thinking what's really applicable. And we've heard a number of people say it in different ways, I think you mentioned it. The, very big difference between organizations that are happenstance in the way they came about structurally and from a leadership perspective and organizations that are in intentional about how they ended up.
[00:08:32] John Deverill: Yeah.
[00:08:33] Tim Brewer: In all your time, both the Army, GE and with the NHS, can you share some of the practical things that you would try and take a leader that you observe having the symptoms of reactive org design, or
[00:08:48] John Deverill: How do you know when you need it, you mean? You need it, you mean? The symptomology of org design, discuss.
Yeah.
[00:08:54] Rory Mustan: as a, as a healthcare professional.
[00:08:55] John Deverill: As a
[00:08:56] Tim Brewer: blue pill or the red
[00:08:57] John Deverill: ex-military businessman, kind of healthcare professional person. When
[00:09:00] Tim Brewer: you walk within five minutes like, okay, this place is completely reactive.
[00:09:05] John Deverill: Five minutes is too soon. I think depending on the nature of the organization. That's right, unless you go in and it's like there's dust everywhere and nobody's, unless it's completely stopped working that day or for some other reason. Okay, because I believe that organizations are beneficially organized around strategy. And so therefore strategy is in the strategy. That's what success looks like. If it's not clear what success looks like, people are just doing a job, then that's a symptom. If they're not, if the strategy is not being achieved, then that's a symptom.
If people are complaining that, why is it that people over there are always doing what they're doing and we're doing something which is completely different, we don't really understand how it fits together. If an organization hasn't been looked at from a design perspective for the last two years, it needs redesign in all it, it will need because, because of the pace of drift. Organizations evolve and grow a bit like a garden. They need trimming and cutting back, and trees get overgrown and you have to cut 'em down. With climate change, which is a change in the business environment, you have to change the nature of the whole thing. Sometimes. So if you go into an unkempt business or an unkempt garden, you need to do something. If you're going to do something, do it deliberately or you could, there are two approaches, maybe more. Okay. There's one which is you could let your garden grow wild. Yeah. And see what happened.
[00:10:24] Rory Mustan: Rewild, you could
[00:10:24] John Deverill: could rewild. Exactly. And then you'll find that you don't really have a garden anymore. It's something completely different. Or you can be deliberate about it and figure out what's the environment gonna be in a couple of years time and design something that is suitable for that purpose. And I think now as well, especially, org design is never done because the world keeps changing. You don't need to director a strategy necessarily, but you need to have a strategic function, which means that you're looking out not in all the time, and have that geared to something else in an organization, which means you can change it or the organization can change to meet the anticipated needs that they will be soon.
[00:11:03] Rory Mustan: I'm really interested in that, I looking out rather than in, can you delve into that a bit more?
[00:11:07] John Deverill: In an organization, depending on the size, it's a bit like a family. Everybody knows everybody to a degree. And if it's very, very big, it's a family of families, it's it sort of society and stuff like that. And because humans are what they are, politics build up within the family, the distant bits and close bit. Mm-hmm. And that kind of stuff. And it gets endlessly fascinating. And then there's people worrying about their careers within the family and can they move further up into sales and marketing or into the exciting field of commercial and accounts or whatever it is. So there's lots of internal stuff and there'll be promotion boards and reviews and regulatory checks and stuff like that. And all of that is necessary and important. But meanwhile, the world is changing out there. And the whole thing may be pointing in completely the wrong direction while everybody's fascinatingly doing what they naturally do. It's a bit tribal, I think, in a way
[00:11:56] Rory Mustan: they're incubated. They've become almost systematized or institutionalized around their own organization?
[00:12:03] John Deverill: Yes. You could, I suppose I haven't thought about it, Rory, but I think, I think you could view an, an organization as an institution and so people get organized and they get institutionalized.
[00:12:13] Rory Mustan: Yeah.
[00:12:14] John Deverill: Yeah. Actually here at EODF, there are some remarkable small organizations of really buzzy, youthful headed people who probably consciously change their organizations all the time, but that's a bit unusual. The real world, I don't think is like that. People like to have security in a job, so they know where their money's coming from, so they can feed their kids so they can pay their mortgages and get their houses and that means having a career, and that means institutionalization.
[00:12:38] Rory Mustan: I'm, I'm interested in something you mentioned earlier on, going back to the healthcare conversation around I can't remember the exact description you gave, but it was not intentional that the org design is not intentional it's, I think organic. Was kind of the, the sense that you gave? Yeah. What, what's the cause and effect of that .
[00:12:54] John Deverill: Inattention? I think it's so organizations evolve, don't they? They evolve in the healthcare context. Hundreds of years ago, people got the license to practice and it, but it didn't really get regulated until a few hundred years ago.
But then the way it was regulated was literally young men. And it was men learning at the knee of, much older men on how to do surgery and stuff like that along an apprenticeship model. And then whole kind of societies and things spawned from that. And there were various schools in Europe, and that has evolved through the Royal Colleges in London, in the NHS's case and that kind of stuff, without too much change to where we are today. And it's extremely professional and very highly evolved and has been without much, I would say, significant challenge for the last 200 years.
And the thing is in the healthcare environment, and this is a healthcare thing, but I don't think it's only about healthcare, where you are reliant on such considered and deep expertise, you are utterly reliant on these guys. But the way these guys are is they, you are dependent upon them, it's actually quite difficult. To get them to embrace a new technology that you think is a really great idea because you, it works and you've seen it and it's, healthcare is so expensive and we have to do things that means that we absolutely have to change. But still, these guys are still in, in a model that has been there for many hundreds of years when hospitals and all that sort of thing have evolved around them really, that's, that's the way it works.
[00:14:36] Rory Mustan: Yeah. And you've come from a background in, in military where, the emphasis is On taking new technology on and taking new ideas on all the time. So it's, for you, you've had years of training in that, and do you find that, is that something that is useful in what you do in healthcare,
[00:14:53] John Deverill: the military experience, I think so.
[00:14:55] Rory Mustan: Around the innovation or the, the, the, the kind of the change of embracing new ideas, embracing new technologies as they do in the military?
[00:15:03] John Deverill: So in terms of what I do, I think the. The. Ability to see what the potential of new technology is and the limitation as well, because there's no such thing as total upside is there. But also to see sympathetically where people are with all of that history and tradition, that sort of stuff, and marry the two together. That's what all real org design, I'm just a guy, the people here are professional org designers in a way that I wouldn't describe myself, but it is that ability to bring people on a journey, which is leadership with great clarity of view about what the future is, embracing new technology as you do and also the wherewithal if you like, to attempt to create an organization of which the end point is that they're changing, in other words, there is no end point. Because the, the pace of change, not in just in healthcare, in everything, in the military, as you've seen with drones in Ukraine, and that kind of stuff is changing at such a rate that the world is changing, as I said a bit earlier on, faster than we can cope. So we, what we mustn't do now is consciously create static organizations, except maybe you can sub organizations, I guess you can, some basic organizational precepts you can keep right at the core, but the rest of it has to be extremely adept, evolutionary, mobile
[00:16:17] Tim Brewer: Some practical questions for let's, I'm a, a manager, fallen into a leadership role with five or 600 people
[00:16:25] John Deverill: fallen, being, being
[00:16:27] Tim Brewer: Like someone
[00:16:28] John Deverill: plucked from the workforce on the basis of talent
[00:16:29] Tim Brewer: like, oh, by the way, Now you are leading all these people, probably a, a poorly thought, reactive, reorg that did it, but they're now there and they're thinking, oh, actually, A my organization needs to be agile. Agile and I wanna take a more proactive approach to how I structure structure my organization and resource strategy, assuming they're convinced and comfortable that their strategy is on point, what are the kind of practical things you would sit and talk to your leaders about in your current role or in previous roles to help them mobilize things within their organization to be more agile or be more intentional?
[00:17:11] John Deverill: There are lots of tools and techniques which are out there. There are people which a few years ago there weren't, who are experts in this thing called organizational design, which is not completely intuitive, I think because they, if you're going to design an organization, why don't use the benefit of experience from elsewhere, and I think that's the thing, then it could be that you, depending on the organization, that there are, you have access to a host of people who are really good at this for some reason, but it's a bit unlikely. So the best thing to do is to get challenged from outside. As I said a bit before, look out, not in. If you trying to change organizations to be the best they can be from completely from within is intensely difficult because there are so many naturally, entirely human and understandable reasons to maintain the status quo and keep things the way they are 'cause we like it the way it is and that kind of thing. But without that external challenge, it's difficult to get the best of new ideas to, to form a real vision, which might actually change the strategy perfectly form that they, it might have been. A strategy isn't what you write down, by the way, anyway, a strategy is what you end up doing. I think so deliberately what you end up doing, and I think the best thing about forming a strategy if you do it well is the teamwork and the engagement, including the external stuff that you do in bringing it about, so that at the end you might have a document, which is very important with strategy and open in emergencies and things like that written on top of it.
But more importantly than that, you've got a bunch of people who are very, very clear, because they had a hand in shaping it about what you're gonna do together to make it better than it is right now. And I think you can also, I prefer there's a, there's a term isn't there, called burning platform, we must have a burning platform to establish this change. But there's somebody, and it might have been at a previous conference, said a burning platform is something you jump off the sea to avoid rather than something you run towards. So it's better to establish a glittering vision of the future as to why it will be better.
[00:19:08] Tim Brewer: Mm-hmm.
[00:19:08] John Deverill: Which will really motivate people while you write that strategy. And then you've actually, if you do it that kind of way, then you've got a kind of pre-motivated core team to help you drive the change. If you can't identify the people who would be with you in making the journey, then you've got a problem because maybe that means that whatever journey you're going to want to take is not gonna work, which means you might need to think about changing the people in your team so that you can have a core team so you can do something. And that's like a precondition for success. So maybe that's the thing i'd say in addition to the external challenge or idea or input or something, to bring about a change, you need a coalition of the willing. If you can't identify that coalition, you can't bring about the change. Therefore, don't write a strategy until you have.
[00:19:51] Rory Mustan: It's an interesting concept. It's come, come up quite a bit this week the conversation around strategy led or people led. And I guess what you're talking about is it's both and ,
[00:20:01] John Deverill: Yeah, it's definitely not a dichotomy. Strategy is what you do, you're gonna do it with people, therefore you have to have the people. If you're in an organization with the 600 people that you mentioned before, Tim, then you'd be better off starting off another organization using some of the budget for your 600, if you haven't got the right people on the bus to bring you a board, grow a completely different business model, and then gradually migrate some of the old people into the new thing. Because changing from within is too hard. I think you have to have the people with you.
[00:20:30] Rory Mustan: You're one of the small number of people here who would probably not consider themselves an org designer in the strictest sense. This is my first week at EODF and being amongst so many org designers and it's been interesting to see the types of people who do it as a profession and a lot, a lot of the People who listen to this podcast wouldn't be familiar with org design or org designers as a profession. What do you think are the qualities that make great org designers or some of the qualities that make great org designers?
[00:20:59] John Deverill: I think like everybody in the field of management consultancy, which they, they basically are, they need to have a tool set, but a tool set's just a tool set and you can read books and stuff like that. So I think basically it is the ability to and communicate very clearly strategy and rationale for redesign and the EQ to engage with people from all walks of life and to bring them on a journey. I love coming to this conference because you end up meeting some completely weird people, but everybody here is marvelous, that they're all very bright and they're all very naturally engaging. And I think it's that combination of brightness and engaging that you, that I would look for. It is that ultra combination that, that special combination of people skills and not necessarily academic, but the strategic viewpoint. You want somebody that others will respect, and look, not necessarily up to, but at least, at least as a peer and maybe somebody to look up to. Because I think it's the same as when you hire somebody into an organization, the best decisions that you make are the hiring decisions. And when you bring in a consultant, you need somebody who's gonna make you look good because you've brought in somebody whom others might aspire to be. And for me, that's the kind of the kind of rationale. So I don't hire many consultants, obviously.
[00:22:31] Rory Mustan: It's interesting you said academic 'cause I, one of the things I feel about most of the people I've spoken to is that they're all extremely curious, for sure. And that's an unusual quality, sometimes
[00:22:43] John Deverill: curiosity?
[00:22:44] Rory Mustan: In a professional sense. I think sometimes people are worried, are worried about the vulnerability it exposes of saying, I don't know, something. But I think that in the room here at EODF I've definitely felt that sense of people being comfortable just saying, okay, I don't know. So I'll ask the question.
[00:23:01] John Deverill: I think you're quite right to hit on something there. Going back to what we were saying about stale organizations or whatever, we didn't use that word, but it is the absence of curiosity about why is that? And there, I think it's quite rare actually to find in most organizations, because they're so in it, they forget that they can be curious about something and maybe the environment isn't right for them to ask curious questions. But it's a special quality and I'm, I'm glad you mentioned it.
[00:23:26] Tim Brewer: A lot of leaders choose to outs outside outsource their org design completely, will be completely reliant on external consultants. Maybe going maybe going back to your garden analogy, they wait till the garden's way overgrown and then they'll bring in the. the most expensive consultants to write a gorgeous PowerPoint
[00:23:45] John Deverill: about what your garden will be.
[00:23:47] Tim Brewer: About the, the picture of, yeah,
[00:23:49] John Deverill: What need to move into a new area of business. I'm getting and
[00:23:51] Tim Brewer: How do you think about outsourcing, completely outsourcing org design,
[00:23:56] John Deverill: I would never do it. I think so my, my own viewpoint on this is that as a leader of an organization, you should have your head around it in all respects. And the idea of contracting out the fundamentals of what your organization is, is it's just something I, I personally would never do.
I wouldn't mind getting the external, getting ideas is partly why I'm here. And getting somebody who's a real expert in to challenge the team, but it has to be yours and theirs. Otherwise, I think you've probably got it wrong in, in my book.
[00:24:27] Tim Brewer: So from a expert consultant perspective, it's really like a partnership you're looking for when you bring someone in, not an, a complete outsource of that
[00:24:36] John Deverill: Yeah. Function. No, no, no. You can't. It's like Kenichi Ohmae once, I don't read many management books, but I read this one while I was still in the British Army and it, I thought at the time, it's the best strategy book I'd read. Kenichi Ohmae was an ex McKinsey's consultant, I think, and he wrote The key factors for success of an organization that the things you must do, outsource the rest, focus on what you're really good at, and you keep the crown jewels and who you are and what you do is the biggest crown jewel of them all I think. So you just don't do it. It would be basically you are saying okay, I have the honor to serve you as your leader. You'd say to your team, but I'm going to contract out that, that this really key bit and I'll come back when it's over. Have a nice day. I'm off to Mauritius. It's just, it doesn't make sense. It doesn't, doesn't stack up.
[00:25:17] Tim Brewer: John, we really appreciated you coming and spending time on the podcast, sharing with our listeners.
[00:25:23] Rory Mustan: Yeah, it's been fantastic.
[00:25:24] Tim Brewer: We typically ask for consultants if people want get in contact with you, but I know you are not interested in doing external work, you're very busy I'm sure in your core roles.
[00:25:35] John Deverill: If anybody wants to talk to me, that's absolutely fine, but I don't really work as a consultant as such anymore.
[00:25:40] Tim Brewer: You just on LinkedIn is the best place to find you.
[00:25:42] John Deverill: LinkedIn is a good place to find me.
[00:25:43] Tim Brewer: We do up an author page, so we'll chuck your LinkedIn link there for the podcast. Thank you very much John for coming Org Design P odcast. Have a great rest of the conference and to Italy and Milan you've been wonderful. Thanks Rory. Thanks everyone. Bye-bye.
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